Basic Information
Provider Information
NPI: 1427354216
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PATEL
FirstName: ANURADHA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
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Mailing Information
Address1: 2 SOUTH AVE
Address2:  
City: CARTERSVILLE
State: GA
PostalCode: 301203559
CountryCode: US
TelephoneNumber: 7703870544
FaxNumber: 7703870543
Practice Location
Address1: 960 JOE FRANK HARRIS PKWY SE
Address2: ANESTHESIA DEPT
City: CARTERSVILLE
State: GA
PostalCode: 301202129
CountryCode: US
TelephoneNumber: 7703821530
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/27/2011
LastUpdateDate: 08/02/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/02/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000XRN173777GAN Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 
207LC0200X173777GAY Allopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine

No ID Information.


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